chiropractic board; complaints; training; authority.

HB2227 - 572R - I Ver

REFERENCE TITLE:
chiropractic board; complaints; training; authority.

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

HB 2227

Introduced by

Representative
Blackman

AN
ACT

amending section 32-900, Arizona
Revised Statutes; amending title 32, chapter 8, article 1, Arizona Revised
Statutes, by adding section 32-900.01; amending section 32-904,
Arizona Revised Statutes; amending title 32, chapter 8, article 1, Arizona
Revised Statutes, by adding section 32-904.01; amending sections 32-905,
32-921, 32-923 and 32-924, Arizona Revised Statutes; amending
title 32, chapter 8, article 2, Arizona Revised Statutes, by adding section 32-924.01;
amending sections 32-929 and 32-934, Arizona Revised Statutes;
relating to the state board of chiropractic examiners.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 32-900, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-900.

Definitions

In this chapter, unless the context otherwise requires:

1. "Advisory letter" means a
nondisciplinary letter to notify a licensee that either:

(a) While there is insufficient evidence to support
disciplinary action, the board believes that continuation of the activities
that led to the investigation may result in further board action against the
licensee.

(b) The violation is a minor or technical violation
that is not of sufficient merit to warrant disciplinary action.

(c) The violation is a minor or technical violation,
and while the licensee has demonstrated substantial compliance through
rehabilitation or remediation that has mitigated the need for disciplinary
action, the board believes that repetition of the activities that led to the
investigation may result in further board action against the licensee.

2. "Board" means the state board of
chiropractic examiners.

3. "Certification" means that a doctor of
chiropractic has been certified by the board in a specialty of chiropractic as
provided by law.

4. "Chiropractic assistant" means an
unlicensed person who has completed an educational training program approved by
the board, who assists in basic health care duties in the practice of
chiropractic under the supervision of a doctor of chiropractic and who performs
delegated duties commensurate with the chiropractic assistant's education and
training but who does not evaluate, interpret, design or modify established
treatment programs of chiropractic care or violate any statute.

5. "Doctor of chiropractic"

or "chiropractic physician"
means a natural person who holds a
license to practice chiropractic pursuant to this chapter.

6. "License" means a license to practice
chiropractic.

7. "Member" includes a
doctor of chiropractic who is employed with, contracted with or otherwise
affiliated with another licensee.

8. "Patient safety" means
actions associated with chiropractic care that are taken to prevent errors and
adverse effects to patients.

7.

9.
"Physical
medicine modalities" means any physical agent applied to produce
therapeutic change to biologic tissues, including thermal, acoustic,
noninvasive light, mechanical or electric energy, hot or cold packs,
ultrasound, galvanism, microwave, diathermy and electrical stimulation.

8.

10.
"Therapeutic
procedures" means the application of clinical skills and services,
including therapeutic exercise, therapeutic activities, manual therapy
techniques, massage and structural supports, to improve a patient's
neuromusculoskeletal condition.
END_STATUTE

Sec. 2. Title 32, chapter 8, article 1, Arizona
Revised Statutes, is amended by adding section 32-900.01, to read:

START_STATUTE
32-900.01.

Unprofessional conduct; board prohibition

A. In this chapter, for the PURPOSES
of disciplining a doctor of chiropractic, any of the following whether
occurring in this state or elsewhere constitutes Unprofessional conduct:

1. Failing to disclose, in writing,
to a patient or a third-party payor that the licensee has a financial
interest in a diagnostic or treatment facility, test, good or service when
referring a patient for a prescribed diagnostic test, treatment, good or
service and that the diagnostic test, treatment, good or service is available
on a competitive basis from another health care provider. This
paragraph does not apply to a referral by one licensee to another within a
group of licensees who practice together. This paragraph applies
regardless of whether the referred service is provided at the licensee's place
of practice or at another location.

2. Knowingly making a false or
misleading statement to a patient or a third-party payor.

3. Knowingly making a false or
misleading statement, providing false or misleading information or omitting
material information in any oral or written communication, including
attachments, to the board, board staff or a board representative or on any form
required by the board.

4. Knowingly filing with the board an
application or other document that contains false or misleading information.

5. Failing to create an adequate
patient record that includes the patient's health history, clinical
impressions, examination findings, diagnostic results, x-ray films or
digital imaging if taken, x-ray or digital imaging reports, a treatment
plan, notes for each patient visit and a billing record. The notes
for each patient visit must include the patient's name, the date of service,
the doctor of chiropractic's findings, a description of any service rendered
and the name or initials of the doctor of chiropractic who provided services to
the patient.

6. Failing to maintain the
information required by paragraph 5 of this subsection for a patient for at
least six years after the last treatment date or, for a minor, six years after
the minor's eighteenth birthday.

7. Failing to provide written notice
to the board about how to access the patient records of a chiropractic practice
that is closed by providing, at a minimum, the physical address, telephone
number and full name of a person who can be contacted regarding where the
records are maintained for at least six years after each patient's last
treatment date or a minor patient's eighteenth birthday.

8. Failing to do any of the
following:

(
a
) Release a
copy of all requested patient records as prescribed in paragraph 5 of this
subsection, including the original or a diagnostic quality radiographic copy of
x-rays or digital imaging, to another licensed physician, the patient or
the patient's authorized agent within ten business days after receiving a
written request to do so. This subdivision does not require the
release of a patient's billing record to another licensed physician.

(
b
) Release a
copy of any specified portion or all of a patient's billing record to the
patient or the patient's authorized agent within ten business days after
receiving a written request to do so.

(
c
) In the case
of a patient or a patient's authorized agent who has verbally requested the
patient record, provide the patient record.

(
d
) Return
original x-rays or digital imaging to a licensed physician within ten
business days after receiving a written request to do so.

(
e
) Provide
copies of patient records to another licensed physician, the patient or the
patient's authorized agent free of charge in violation of title 12, chapter 13,
article 7.1.

9. Representing that the licensee has
certification in a specialty area in which the licensee does not have
certification or has academic or professional credentials that the licensee
does not have.

10. Failing to provide to a patient
on request documentation of the licensee's certification by the board in a
specialty area or the licensee's academic certification, degree or professional
credentials.

11. Practicing or billing for
services under any name other than the name by which the doctor of chiropractic
is licensed by the board, including a corporate, business or other licensed
health care provider's name, without first notifying the board in writing.

12. Suggesting or having sexual
contact, as defined in section 13-1401, in the course of patient
treatment or within three months after the last chiropractic examination,
treatment or consultation with an individual with whom a consensual sexual
relationship did not exist before the doctor of chiropractic-patient
relationship was established.

13. Intentionally viewing a
completely or partially disrobed patient in the course of an examination or
treatment if the viewing is not related to the patient's complaint, diagnosis
or treatment under current practice standards.

14. Intentionally misrepresenting the
effectiveness of a treatment, diagnostic test or device.

15. Penetrating a patient's rectum by
a rectal probe or device to administer an ultrasound, diathermy or other
modality.

16. Using ionizing radiation in
violation of section 32-2811.

17. Promoting or using diagnostic
testing or treatment for research or experimental purposes without doing both
of the following:

(
a
) Obtaining
written informed consent from the patient or the patient's authorized agent
before the diagnostic test or treatment, including disclosing to the patient or
authorized agent any research protocol, contract the licensee has with researchers,
if applicable, and information on the institutional review committee used to
establish patient protection.

(
b
) Conforming
to generally accepted research or experimental criteria, including following
protocols, maintaining detailed records, periodically analyzing results and
periodically submitting to review by a peer review committee.

18. Having a professional connection
with an illegal practitioner of chiropractic, misrepresenting oneself as a
current or past board member, a current or past board staff member or a current
or past board chiropractic consultant or claiming professional superiority in
the practice of chiropractic under section 32-925.

19. Violating the health insurance
portability and accountability act.

20. Habitually using or having
habitually used alcohol, narcotics or stimulants to the extent of
incapacitating the licensee in performing professional duties.

21. Being Convicted by a court of
competent jurisdiction of a class 1, 2, 3, 4 or 5 felony.

22. In any other jurisdiction, having
an action taken against the licensee's professional license, having any limit
or restriction placed on the license, having the license placed on probation or
suspension or revoked or surrendered as a disciplinary measure or having a
license application or license renewal denied for a reason related to
unprofessional conduct.

23. Directly or indirectly dividing a
professional fee for patient referrals among health care providers or health
care institutions or between providers and institutions or entering into a
contractual arrangement to that effect. This paragraph does not
prohibit the members of any regularly and properly organized business entity
recognized by law from dividing fees received for professional services among
themselves as they determine.

24. Violating any federal or state
statute, rule or regulation that applies to the practice of chiropractic.

25. Filing an anonymous complaint
against another licensee.

B. The board may not adopt rules that
alter or amend unprofessional conduct as prescribed in subsection A of this
section.
END_STATUTE

Sec. 3. Section 32-904, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-904.

Powers and duties of the board; rules; removal of executive
director

A. The board may administer oaths, summon witnesses
and take testimony on matters within
its

the
board's
powers and duties.

B. The board shall:

1. Adopt a seal, which shall be affixed to licenses
issued by the board.

2. Adopt rules that are necessary and proper for the
enforcement of this chapter.

3. Adopt rules regarding chiropractic assistants who
assist a doctor of chiropractic, and the board shall determine the
qualifications and regulation of chiropractic assistants who are not otherwise
licensed by law.

4. At least once each fiscal year and before
establishing the amount of a fee for the subsequent fiscal year, review the
amount of each fee authorized in this chapter in a public hearing.

5. Develop policies and procedures
for determining when the board will require a licensee to undergo psychosexual
evaluations and how the board will use the evaluation results.

C. A copy of the rules
adopted
pursuant to this section
shall be filed with the secretary of state
upon

on
adoption as provided by law.

D. The board shall terminate the
executive director of the board for any of the following:

1. Subpoenaing information that is
unrelated to a complaint allegation.

2. Failing to refer to the
appropriate law enforcement agency a complaint or information indicating that a
licensee or certificate holder may have committed a misdemeanor or felony
within two business days after receiving the complaint or information.

3. Advocating in support of or
against a legislative proposal in the executive director's official capacity
before the board has taken a formal position on the proposal in a public
meeting.
END_STATUTE

Sec. 4. Title 32, chapter 8, article 1, Arizona
Revised Statutes, is amended by adding section 32-904.01, to read:

START_STATUTE
32-904.01.

Conflict of interest requirements; annual trainings on conflict
of interest, open meetings and board authority

A. Each board member and employee, on
appointment or hire, shall complete a conflict-of-interest
disclosure form, including an attestation that no conflict exists, if
applicable, and shall update the disclosure form annually.

B. The board shall retain all
conflict-of-interest disclosure forms and make the disclosure forms
and meeting minutes available to the public on request.

C. Each board member and employee, on
hire or appointment and annually thereafter, shall complete a training approved
by the attorney general's office on the following:

1. Conflict-of-interest
requirements, processes and disclosure forms, including how this state's
conflict-of-interest requirements relate to their individual roles
and responsibilities.

2. Open meetings law requirements.

3. The board's authority to
investigate complaints and issue subpoenas.
END_STATUTE

Sec. 5. Section 32-905, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-905.

Executive director of board; duties; prohibitions; other
personnel; immunity

A. Subject to title 41, chapter 4, article 4, the
board shall appoint an executive director who is not a member of the board and
who
shall serve
serves
at the
pleasure of the board.

B. The executive director shall:

1. Keep a record of the proceedings of the board.

2. Collect all monies due and payable to the board.

3. Deposit, pursuant to sections 35-146 and 35-147,
all monies received by the board in the board of chiropractic examiners fund.

4. Prepare bills for authorized expenditures of the
board and obtain warrants from the director of the department of administration
for payment of bills.

5. Administer oaths.

6. Act as custodian of the seal, books, minutes,
records and proceedings of the board.

7. At the request of the board, do and perform any
other duty not prescribed for the executive director elsewhere in this chapter.

8
.
Ensure that
the board follows all applicable laws and rules and complies with all reporting
requirements.

9. Advise the board if any
contemplated action is beyond the scope of the authority granted to the board
pursuant to this chapter. The executive director may provide the
advice in executive session, but if the board disregards the advice the
executive director shall state potential concerns in an open meeting of the
board.

10. Prepare and maintain a discipline
matrix for use by the board to ensure that all licensees are treated
consistently, to the best of the board's ability, based on the specific
allegation at issue, when the board contemplates imposing any form of
discipline. The matrix must briefly outline material facts of all
past cases in which discipline was imposed without identifying any specific
licensee or complainant other than by potential file number or other reference
and must specify the level of discipline imposed. The matrix must be
available to any licensee against whom a complaint has been filed and a formal
investigation has been opened, including the licensee's counsel.

11. Consistent with this chapter,
classify each complaint on submission to the board according to policies
adopted by the board that prioritize the allocation of board resources and the
investigation and adjudication of complaints.

C. The executive director may not:

1. Advocate in support of or against
a legislative proposal in the executive director's official capacity until the
board has taken a formal position on the proposal in a public meeting.

2. Encourage licensees or the public
to support or oppose any legislation.

C.

D.
Subject
to title 41, chapter 4, article 4, the board may employ other personnel as it
deems necessary to carry out the purposes of this chapter.

D.

E.
The
executive director and
a
any

person acting pursuant to the executive director's direction
is
are
personally immune from civil liability for all actions
taken in good faith pursuant to this chapter.
END_STATUTE

Sec. 6. Section 32-921, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-921.

Application for license; qualifications of applicant; fee;
background investigations

A. A person who wishes to practice chiropractic in
this state shall submit a complete application to the board at least forty-five
days before the next scheduled examinations on a form and in the manner
prescribed by the board.

B. To be eligible for an examination and licensure,
the applicant shall:

1. Be a graduate of a chiropractic college that
both:

(a) Is accredited by or has status with the council
on chiropractic education or is accredited by an accrediting agency recognized
by the United States department of education or the council on postsecondary
accreditation.

(b) Teaches a resident course of four years of not
less than nine months each year, or the equivalent of thirty-six months
of continuous study, and that comprises not less than four thousand credit
hours of resident study required to receive a degree of doctor of chiropractic
(D.C.).

2. Be physically and mentally able to practice
chiropractic skillfully and safely.

3. Have a certificate of attainment for part I and
part II and a score of three hundred seventy-five or more on part III or
IV of the examination conducted by the national board of chiropractic
examiners.

C. The board may refuse to give an examination or
may deny licensure to an applicant who:

1. Fails to qualify for an examination or licensure
under subsection B of this section.

2. Has had a license to practice chiropractic
refused, revoked, suspended or restricted by a regulatory board in this or any
other jurisdiction for any act that constitutes unprofessional conduct pursuant
to this chapter.

3. Is currently under investigation by a regulatory
board in this or any other jurisdiction for an act that constitutes
unprofessional conduct pursuant to this chapter.

4. Has surrendered a license to practice
chiropractic in lieu of disciplinary action by a regulatory board in this or
any other jurisdiction for an act that constitutes unprofessional conduct
pursuant to this chapter.

5. Has engaged in any conduct that constitutes
grounds for disciplinary action pursuant to section
32-924
32-900.01
or board rules.

D. On applying, the applicant shall pay to the
executive director of the board a nonrefundable fee of not more than $325 as
established by the board. The board shall keep a register of all
applicants and the result of each examination.

E. In order to determine an applicant's eligibility
for examination and licensure, the board
may
shall
require the applicant to submit a full set of
fingerprints to the board.� The board shall submit the fingerprints to the
department of public safety for the purpose of obtaining a state and federal
criminal records check pursuant to section 41-1750 and Public Law 92-544.�
The department of public safety may exchange this fingerprint data with the
federal bureau of investigation.� The board shall charge each applicant a fee
that is necessary to cover the cost of the investigation. The board
shall forward this fee to the department of public safety.
END_STATUTE

Sec. 7. Section 32-923, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-923.

Change of address; annual renewal fee; failure to renew; waivers;
definition

A.
Every
Each

person who is licensed pursuant to this chapter shall notify the board in
writing of any change in residence or office address and telephone number
within thirty days after that change. The board shall impose a
penalty of $50 on a licensee who does not notify the board as required by this
subsection.

B. Except as provided in section 32-4301,
every
each
person who is licensed to
practice chiropractic in this state shall annually make a renewal application
to the board before the last day of the licensee's birth month after original
issuance of a license and shall pay a renewal license fee of not more than $225
as established by the board. The renewal application shall be made
on a form and in a manner prescribed by the board. At least thirty
days before the renewal application and renewal fee are due, the board shall
send by first class mail a renewal application and notice requiring license
renewal and payment of the renewal fee.

C. The board shall administratively suspend a
license automatically
after ninety days
if the licensee
does not submit a complete application for renewal and pay the renewal license
fee as required by this section.
� If the licensee completes the
renewal application and pays the renewal license fee within ninety days after
the due date, the licensee's renewal license shall be backdated to the
expiration date of the license.

D. The board may reinstate a license if the person
completes an application for reinstatement as prescribed by the board, complies
with the continuing education requirements for each year that the license was
suspended, pays the annual renewal license fee for each year that the license
was suspended and pays an additional fee of $200. An applicant who
does not request reinstatement within two years after the date of suspension
shall apply for a license as a new candidate pursuant to section 32-921
or 32-922.01.

E. The board may waive the annual renewal license
fee if a licensee presents evidence satisfactory to the board that the licensee
has permanently retired from the practice of chiropractic and has paid all fees
required by this chapter before the waiver.

F. During the period of waiver the retired licensee
shall not engage in the practice of chiropractic. A violation of
this subsection subjects the retired licensee to the same penalties as are
imposed in this chapter on a person who practices chiropractic without a
license.

G. The board may reinstate a retired licensee to
active practice on payment of the annual renewal license fee and presentation
of evidence satisfactory to the board that the retired licensee is
professionally able to engage in the practice of chiropractic and still
possesses the professional knowledge required. After a hearing, the
board may refuse to reinstate a retired licensee to active practice under this
subsection on any of the grounds prescribed in section
32-924
32-900.01
.

H. For the purposes of this section,
"administratively suspend" means a nondisciplinary action that is
imposed for failure to renew a license and that requires the licensee to
suspend practice until renewal requirements are met.
END_STATUTE

Sec. 8. Section 32-924, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-924.

Complaints; investigations; hearing; civil penalty

A. The following are grounds for
disciplinary action, regardless of where they occur:

1. Employment of fraud or deception in
securing a license.

2. Practicing chiropractic under a
false or assumed name.

3. Impersonating another practitioner.

4. Habitual use of alcohol, narcotics
or stimulants to the extent of incapacitating the licensee for the performance
of professional duties.

5. Unprofessional or dishonorable
conduct of a character likely to deceive or defraud the public or tending to
discredit the profession.

6. Conviction of a misdemeanor
involving moral turpitude or of a felony.

7. Gross malpractice, repeated malpractice
or any malpractice resulting in the death of a patient.

8. Representing that a manifestly
incurable condition can be permanently cured, or that a curable condition can
be cured within a stated time, if this is not true.

9. Offering, undertaking or agreeing
to cure or treat a condition by a secret means, method, device or
instrumentality.

10. Refusing to divulge to the board
on demand the means, method, device or instrumentality used in the treatment of
a condition.

11. Giving or receiving or aiding or
abetting the giving or receiving of rebates, either directly or indirectly.

12. Acting or assuming to act as a
member of the board if this is not true.

13. Advertising in a false, deceptive
or misleading manner.

14. Having had a license refused,
revoked or suspended by any other state or country, unless it can be shown that
the action was not taken for reasons that relate to the ability to safely and
skillfully practice chiropractic or to any act of unprofessional conduct.

15. Any conduct or practice contrary
to recognized standards in chiropractic or any conduct or practice that
constitutes a danger to the health, welfare or safety of the patient or the
public or any conduct, practice or condition that impairs the ability of the
licensee to safely and skillfully practice chiropractic.

16. Violating or attempting to
violate, directly or indirectly, or assisting in or abetting the violation of
or conspiring to violate any of the provisions of this chapter or any board
order.

17. Failing to sign the physician's
name, wherever required, in any capacity as "chiropractic doctor",
"chiropractic physician" or "doctor of chiropractic" or
failing to use and affix the initials "D.C." after the physician's
name.

18. Failing to place or cause to be
placed the word or words "chiropractic", "chiropractor",
"chiropractic doctor" or "chiropractic physician" in any
sign or advertising media.

19. Using physical medicine modalities
and therapeutic procedures without passing an examination in that subject and
without being certified in that specialty by the board.

20. Using acupuncture without passing
an examination in that subject and without being certified in that specialty by
the board.

21. Engaging in sexual intercourse or
oral sexual contact with a patient in the course of treatment.

22. Billing or otherwise charging a
patient or third-party payor for services, appliances, tests, equipment, an x-ray
examination or other procedures not actually provided.

23. Intentionally misrepresenting to
or omitting a material fact from the patient or third-party payor concerning
charges, services, appliances, tests, equipment, an x-ray examination or
other procedures offered or provided.

24. Advertising chiropractic services,
appliances, tests, equipment, x-ray examinations or other procedures for
a specified price without also specifying the services, procedures or items
included in the advertised price.

25. Advertising chiropractic services,
appliances, tests, equipment, x-ray examinations or other procedures as
free without also disclosing what services or items are included in the
advertised service or item.

26. Billing or charging a patient or
third-party payor a higher price than the advertised price in effect at the
time the services, appliances, tests, equipment, x-ray examinations or
other procedures were provided.

27. Advertising a specialty or
procedure that requires a separate examination or certificate of specialty,
unless the licensee has satisfied the applicable requirements of this chapter.

28. Solicitation by the licensee or by
the licensee's compensated agent of any person who is not previously known by
the licensee or the licensee's agent, and who at the time of the solicitation
is vulnerable to undue influence, including any person known to have
experienced any of the following within the last fifteen days:

(a) Involvement in a motor vehicle
accident.

(b) Involvement in a work-related
accident.

(c) Injury by, or as the result of
actions of, another person.

B.

A.
The
board on its own motion or on receipt of a complaint may investigate any
information that appears to show that a doctor of chiropractic is or may be in
violation of this chapter or board rules or is or may be mentally or physically
unable to safely engage in the practice of chiropractic.� The board shall
notify the licensee as to the content of the complaint as soon as is
reasonable. Any person who reports or provides information to the
board in good faith is not subject to civil damages as a result of that
action.
The scope of an investigation pursuant to
this section is limited to the information contained in the initial complaint
or the information that the board has in its possession at the time of the
board's motion to investigate.

C.

B.
The
board may require a licensee
who is
under investigation
pursuant to this section to be interviewed by the board or its
representatives. The board may require a licensee who is under
investigation pursuant to this section to undergo, at the licensee's expense,
any combination of medical, physical or mental examinations that the board
finds necessary to determine the licensee's competence.

D.

C.
If
the board finds based on the information it receives under subsections
B

A
and
C

B
of this section that the public health, safety or
welfare imperatively requires emergency action, and incorporates a finding to
that effect in its order, the board may order a summary suspension of a license
pending proceedings for revocation or other action.� If the board takes this
action,
it

the board
shall also
serve the licensee with a written notice that states the charges and that the
licensee is entitled to a formal hearing within sixty days.

E.

D.
If,
after completing its investigation, the board finds that the information
provided pursuant to this section is not of sufficient seriousness to merit
disciplinary action against the licensee,
it

the board
may take any of the following actions:

1. Dismiss the complaint if in the board's opinion
the information is without merit or does not warrant sanction of the licensee.

2. Issue an advisory letter. An advisory
letter is a nondisciplinary action and is a public document.

3. Issue a nondisciplinary order requiring the
licensee to complete a prescribed number of hours of continuing education in an
area or areas prescribed by the board to provide the licensee with the
necessary understanding of current developments, skills, procedures or
treatment.�
Failure to complete a nondisciplinary order requiring
continuing education is a violation of subsection A, paragraph 16 of this
section.

F.

E.
The
board may request a formal interview with the licensee concerned. At
a formal interview the board may receive and consider pertinent documents and
sworn statements of persons who may be called as witnesses in a formal
hearing.�
The board may not subpoena information related to a
licensee's personal finances.
Legal counsel may be present and
participate in the formal interview. If the licensee refuses the
request or if the licensee accepts the request and the results of the interview
indicate suspension or revocation of the license may be in order, the board
shall issue a complaint and order that a hearing be held pursuant to title 41,
chapter 6, article 10. If, after the formal interview, the board
finds that the information provided pursuant to this section is true but is not
of sufficient seriousness to merit suspension or revocation of the license,
it
the board
may take any of the following
actions:

1. Dismiss the complaint if in the board's opinion
the information is without merit or does not warrant sanction of the licensee.

2. Issue an advisory letter. An advisory
letter is a nondisciplinary action and is a public document.

3. Issue an order to cease and desist.

4. Issue a letter of concern.

5. Issue an order of censure.� An order of censure
is an official action against the licensee and may include a requirement for
restitution of fees to a patient resulting from a violation of this chapter or
board rules.

6. Fix a period and terms of probation best adapted
to protect the public health and safety and to rehabilitate or educate the
licensee.� Any costs incidental to the terms of probation are at the licensee's
own expense. Probation may include restrictions on the licensee's license to
practice chiropractic.

7. Impose a civil penalty of not more than
one thousand dollars
$1,000
for each
violation of this chapter.

8. Refuse to renew a license.

9. Issue a disciplinary or nondisciplinary order
requiring the licensee to complete a prescribed number of hours of continuing
education in an area or areas prescribed by the board to provide the licensee
with the necessary understanding of current developments, skills, procedures or
treatment.

F. The board may extend the time to
investigate a licensee if either of the following applies:

1. The complaint relates to the
improper sexual conduct of the licensee.

2. Both of the following apply:

(
a
) The
licensee agrees to the proposed extension.

(
b
) The board
has diligently pursued an investigation within the time frame prescribed
pursuant to this chapter for complaints involving allegations or violations of
unprofessional conduct or malpractice that implicates patient safety.

G. Unless the board extends the time
to investigate pursuant to subsection F of this section, an investigation and
initial review of a complaint shall be completed within ninety days after the
complaint is filed.� If the board determines that a formal hearing is required,
the board shall make a final decision within two hundred twenty days after the
complaint is filed. If the board has not made a final decision on a complaint
after two hundred twenty days, the complaint is deemed administratively closed.

G.

H.
If
the board believes the charge is of such magnitude as to warrant suspension or
revocation of the license, the board shall immediately initiate formal
revocation or suspension proceedings pursuant to title 41, chapter 6, article
10.� The board shall notify a licensee of a complaint and hearing by certified
mail addressed to the licensee's last known address on record in the board's
files.� The notice of a complaint and hearing is effective on the date of its
deposit in the mail. The board shall hold a formal hearing within
one hundred eighty days after that date.

H.

I.
If
the licensee wishes to be present at the formal hearing in person or by
representation, or both, the licensee shall file with the board a written
answer to the charges in the complaint.� A licensee who has been notified of a
complaint pursuant to this section shall file with the board a written response
not more than twenty days after service of the complaint and the notice of
hearing.� If the licensee fails to file an answer in writing, it is deemed an
admission of the act or acts charged in the complaint and notice of hearing and
the board may take disciplinary action pursuant to this chapter without a
hearing.

I.

J.
Any
licensee who, after a hearing, is found to be in violation of this chapter or
board rules or is found to be mentally or physically unable to safely engage in
the practice of chiropractic is subject to any combination of those
disciplinary actions identified in subsection F of this section or suspension
or revocation of the license.� In addition, the board may order the licensee to
pay restitution or all costs incurred in the course of the investigation and
formal hearing in the matter, or both.

K.
If a court
of competent jurisdiction finds that the board acted capriciously against a
licensee without merit and in violation of this chapter, the rules adopted
pursuant to this chapter or the board's policies or procedures, the licensee is
entitled to restitution for all costs incurred relating to the matter in the
course of the investigation or the formal hearing process, or both.

J.

L.
The
board shall report allegations of evidence of criminal wrongdoing to the
appropriate criminal justice agency.

K.

M.
The
board may accept the surrender of an active license from a licensee who admits
in writing to having violated this chapter or board rules.

L. For the purposes of this section,
"solicitation" includes contact in person, by telephone, telegraph or
telefacsimile or by other communication directed to a specific recipient and
includes any written form of communication directed to a specific recipient.

END_STATUTE

Sec. 9. Title 32, chapter 8, article 2, Arizona
Revised Statutes, is amended by adding section 32-924.01, to read:

START_STATUTE
32-924.01.

Criminal complaints; referrals; time frame; board notification

A. If the board receives a complaint
or information indicating that a licensee or certificate holder may have
committed a misdemeanor or felony offense, the board shall refer the matter to
the appropriate law enforcement agency within two business days after receiving
the complaint or information. The board does not need to obtain the
complainant's consent or substantiate the complaint before referring the
complaint to law enforcement. If the board finds, based on the complaint
or information that the board refers to a law enforcement agency, that the
public health, safety or welfare requires emergency action, the board may
restrict, limit or order a summary suspension of the licensee's license or
certificate holder's certificate pending action by the law enforcement agency.

B. The law enforcement agency that
receives the complaint or information pursuant to subsection A of this section
shall inform the board of the outcome of the law enforcement agency's
investigation and whether charges are filed against the licensee or certificate
holder who is the subject of the complaint.� Concurrent with the Law
enforcement agency's investigation, the board may investigate whether the
complaint or information that was referred to the law enforcement agency
constitutes a violation of unprofessional conduct pursuant to section 32-900.01
against the licensee or certificate holder who is the subject of the complaint.

END_STATUTE

Sec. 10. Section 32-929, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-929.

Right to examine and copy evidence; summoning witnesses and
documents; taking testimony; right to counsel; court orders; confidentiality

A.
Except as provided in section 32-924,
subsection E,
in connection with an investigation by the board on its
own motion, the board or its duly authorized agents or employees shall at all
reasonable times have access to, for the purpose of examination, and the right
to copy any documents, reports, records or any other physical evidence of any
person being investigated, or the reports, records and any other documents
maintained by and in possession of any hospital, clinic, physician's office,
laboratory, pharmacy or any other public or private agency, and any health care
institution as defined in section 36-401, if such documents, reports,
records or evidence relate to chiropractic competence, unprofessional conduct
or the mental or physical ability of a doctor of chiropractic to safely
practice chiropractic.

B. For the purpose of all investigations and
proceedings conducted by the board:

1.
Except as provided in section 32-924,
subsection E,
the board on its own initiative, or
upon
on
application of any person involved in the investigation,
may issue subpoenas compelling the attendance and testimony of witnesses
,
or demanding the production for examination or copying
of documents or any other physical evidence if such evidence relates to
chiropractic competence, unprofessional conduct or the mental or physical
ability of a doctor of chiropractic to safely practice chiropractic. Within five
days after the service of a subpoena on any person requiring the production of
any evidence in
his
the person's

possession or under
his
the person's

control,
such
the
person may
petition the board to revoke, limit or modify the subpoena. The
board shall revoke, limit or modify such
a
subpoena if in
its opinion the evidence required does not relate to unlawful practices covered
by this chapter, is not relevant to the charge
which
that
is the subject matter of the hearing or investigation or
does not describe with sufficient particularity the physical evidence whose
production is required.

2. Any person appearing before the board may be
represented by counsel.

3. The superior court,
upon
on
application by the board or by the person subpoenaed, shall
have jurisdiction to issue an order either:

(a) Requiring
such
the
person to appear before the board or the duly authorized
agent to produce evidence relating to the matter under investigation.

(b) Revoking, limiting or modifying the subpoena if
in the court's opinion the evidence demanded does not relate to unlawful
practices covered by this chapter, is not relevant to the grounds for censure,
suspension, revocation, fines or refusal to issue a license pursuant to section

32-924 which
32-900.01 that
is
the subject matter of the hearing or investigation, or does not describe with
sufficient particularity the evidence whose production is
required. Any failure to obey such
an
order of
the court may be punished by
such
the

court as contempt.

C. Patient records, including clinical records,
medical reports, laboratory statements and reports, any file, film, any other
report or oral statement relating to examinations, findings or treatment of
patients, any information from which a patient or
his

the patient's
family might be
identified or information received and records kept by the board as a result of
the investigation procedure outlined in this chapter are not available to the
public.

D.
Nothing in
This section
or
and
any other provision of law
making
that makes
communications between a
chiropractic physician and
his

the
chiropractic physician's
patient a privileged communication
applies
do not apply
to investigations or
proceedings conducted pursuant to this chapter. The board and its
employees, agents and representatives shall keep in confidence the names of any
patients whose records are reviewed during the course of investigations and
proceedings pursuant to this chapter.
END_STATUTE

Sec. 11. Section 32-934, Arizona Revised
Statutes, is amended to read:

START_STATUTE
32-934.

Business entities; registration; fees; medical records protocol;
civil penalty; exemptions; violation; classification

A. A business entity may not offer chiropractic
services pursuant to this chapter unless:

1. The entity is registered with the board pursuant
to this section and rules adopted pursuant to this chapter.

2. The services are conducted by a doctor of
chiropractic
who is licensed pursuant to this chapter
.

B. The business entity must file a registration
application and pay a fee as prescribed by the board by rule.�

C. Registration expires on June 1 of each year.� A
business entity that wishes to renew a registration must submit an application
for renewal as prescribed by the board on an annual basis before the expiration
date and pay a renewal fee as prescribed by the board by rule.� The board shall
prorate the renewal fee for the first year registration renewal based on the
first day of the month that the business entity was registered with the board.�
An entity that fails to renew the registration before the expiration date is
subject to a late fee as prescribed by the board by rule.

D. A business entity must notify the board in
writing within thirty days after any change:

1. In the entity's name, address or telephone
number.

2. In the entity's officers or directors.

3. In the name of any doctor of chiropractic who is
authorized to provide and who is responsible for providing or supervising the
provision of chiropractic services in any facility.

E. The board shall impose a civil penalty as
prescribed by the board by rule on a business entity that does not notify the
board as required by subsection D of this section.

F. A business entity must comply with this chapter
and board rules.

G. A business entity must establish a written
protocol for the secure storage, transfer and access of the medical records of
the business entity's patients.� This protocol must include, at a minimum,
procedures for:

1. Notifying patients of the future locations of
their records if the business entity terminates or sells the practice.

2. Disposing of unclaimed medical records.

3. The timely response to requests by patients or
their representatives for copies of their records.

H. A business entity must notify the board within
thirty days after the entity's dissolution or the closing or relocation of any
facility and must disclose to the board the entity's procedure by which its
patients may obtain their records.

I. The board may impose discipline consistent with
this chapter if an entity violates any statute or board rule.

J. The board shall deposit, pursuant to sections
35-146 and 35-147, civil penalties collected pursuant to this section in the
state general fund.

K. This section does not apply to:

1. A facility
,

business
entity, partnership or other form of business, the majority ownership of which
is
owned by a person who is licensed pursuant to this chapter.

2. A sole proprietorship or partnership that
consists of persons who are licensed pursuant to this chapter.

3. A professional corporation or professional
limited liability company, the shares of which are owned by persons who are
licensed pursuant to this chapter.

4. An administrator or executor of the estate of a
deceased doctor of chiropractic or a person who is legally authorized to act
for a doctor of chiropractic who has been adjudicated to be mentally
incompetent for not more than one year after the date of the doctor of
chiropractic's death or incapacitation.

5. A health care institution that is licensed
pursuant to title 36.

6. A health professional who is not licensed
pursuant to this chapter but who acts within the scope of practice as
prescribed by the health professional's regulatory board.

l. A business entity that is exempt
pursuant to subsection K of this section may submit bills under either the
controlling licensee's individual name or the business entity's name without
notifying the board.

L.

M.
A
business entity that offers chiropractic services pursuant to this chapter
without complying with the registration requirements of this section is guilty
of a class 6 felony.
END_STATUTE

Sec. 12.
Legislative
intent

A. The legislature intends
to hold the state board of chiropractic examiners accountable for its failure
to protect the health, welfare and safety of the public by enforcing the
statutes governing chiropractic practice.

B. The legislature affirms
that the primary function of the state board of chiropractic examiners is to
safeguard the public from potential harm. Activities beyond this mandate should
be managed by the private sector or other state agencies with the appropriate
authority, and any deviation from this mandate will not be tolerated.

C. This act aligns with the
auditor general's special audit findings from December 20, 2024, following a
resolution by the joint legislative audit committee on February 12, 2024, that
include:

1. Ensuring that subpoenas
for complaint investigations are relevant to the complaint.

2. Consistently enforcing
statutes and rules.

3. Properly managing and
reporting criminal allegations.

4. Efficiently addressing
complaints.

5. Ensuring that board
practices and communication with licensees and the public are lawful and do not
include legal advice or misinformation.

6. Eliminating redundancies
by streamlining functions to reduce overlap with other state agencies.

7. Terminating abuses of
power and mismanagement, ensuring accountability.

8. Requiring immediate
reporting of criminal misconduct to law enforcement with penalties for
noncompliance.

9. Ensuring that the board
operates transparently and strictly adheres to its mandate of public
protection.